Amygdala electrical-finger-print (AmygEFP) NeuroFeedback guided by individually-tailored Trauma script for post-traumatic stress disorder: Proof-of-concept

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Randomized clinical trial with a novel self-neuromodulation training in PTSD.

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Demonstration of feasibility of an fMRI-informed EEG model of Amygdala modulation (AmygEFP).

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Individually-tailored trauma-related content as the training feedback interface.

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Results showed reduction of PTSD symptoms following AmygEFP trauma-related feedback training.

Background

Amygdala activity dysregulation plays a central role in post-traumatic stress disorder (PTSD). Hence learning to self-regulate one's amygdala activity may facilitate recovery. PTSD is further characterized by abnormal contextual processing related to the traumatic memory. Therefore, provoking the personal traumatic narrative while training amygdala down-regulation could enhance clinical efficacy. We report the results of a randomized controlled trial (NCT02544971) of a novel self-neuromodulation procedure (i.e. NeuroFeedback) for PTSD, aimed at down-regulating limbic activity while receiving feedback from an auditory script of a personal traumatic narrative. To scale-up applicability, neural activity was probed by an fMRI-informed EEG model of amygdala activity, termed Amygdala Electrical Finger-Print (AmygEFP).

Methods

Fifty-nine adults meeting DSM-5 criteria for PTSD were randomized between three groups: Trauma-script feedback interface (Trauma-NF) or Neutral feedback interface (Neutral-NF), and a control group of No-NF (to control for spontaneous recovery). Before and immediately after 15 NF training sessions patients were blindly assessed for PTSD symptoms and underwent one session of amygdala fMRI-NF for transferability testing. Follow-up clinical assessment was performed at 3- and 6-months following NF treatment.

Results

Patients in both NF groups learned to volitionally down-regulate AmygEFP signal and demonstrated a greater reduction in PTSD symptoms and improved down-regulation of the amygdala during fMRI-NF, compared to the No-NF group. The Trauma-NF group presented the largest immediate clinical improvement.

Conclusions

This proof-of-concept study indicates the feasibility of the AmygEFP-NF process-driven as a scalable intervention for PTSD and illustrates its clinical potential. Further investigation is warranted to elucidate the contribution of AmygEFP-NF beyond exposure and placebo effects.

Publisher Correction: Process-based framework for precise neuromodulation

The original and corrected text is shown in the accompanying Publisher Correction.

The interaction between emotion and executive control: Comparison between visual, auditory, and tactile modalities

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Does working memory load facilitate target detection?

Previous studies demonstrated that increasing working memory (WM) load delays performance of a concurrent task, by distracting attention and thus interfering with encoding and maintenance processes. The present study used a version of the change detection task with a target detection requirement during the retention interval. In contrast to the above prediction, target detection was faster following a larger set-size, specifically when presented shortly after the memory array (up to 400 ms). The effect of set-size on target detection was also evident when no memory retention was required. The set-size effect was also found using different modalities. Moreover, it was only observed when the memory array was presented simultaneously, but not sequentially. These results were explained by increased phasic alertness exerted by the larger visual display. The present study offers new evidence of ongoing attentional processes in the commonly-used change detection paradigm.